From the continuous wave Doppler envelope of the left ventricular outflow tract, one can directly measure the peak velocity (5.4 m/s) and derive the peak pressure gradient from the modified Bernoulli equation, ΔP = 4V², yielding a maximum pressure gradient of 117 mmHg.

Apical 5-chamber and 3-chamber (also known as apical long axis) views allow for an appropriate angle of insonation for this measurement ³.

Peak velocities over 4 m/s and peak gradients exceeding 60 mmHg are indicative of severe aortic stenosis ².

The mean gradient and aortic valve area were not calculated in this limited bedside study, but were consistent with severe aortic stenosis in a subsequent formal echocardiogram.

Quantification of valvular pathology is beyond the scope of focused bedside echocardiography. However, severe aortic stenosis is recognized by trained physicians with good specificity, and may allow for earlier detection if noticed at the point of care and referred to an appropriate expert ¹.